NORTH MAIN MEDICAL-IMESON PARKPA NPI 1326274085

NPI Information

NPI: 1326274085
Provider Name: NORTH MAIN MEDICAL-IMESON PARK,PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
5212 N PEARL ST
JACKSONVILLE, FL
ZIP 32208
Phone: (904) 358-2770
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NORTH MAIN MEDICAL-IMESON PARK,PA is a primary care clinic center in Jacksonville, FL. NORTH MAIN MEDICAL-IMESON PARK,PA NPI is 1326274085. The provider is registered as an organization entity type.

The provider's business location address is:

5212 N PEARL ST
JACKSONVILLE, FL
ZIP 32208-118
Phone: (904) 358-2770
Fax: (904) 353-0490

The provider's authorized official is Josefino P Bargas .
The authorized official title is President and has the following contact phone number (904) 358-2770.

The enumeration date for this NPI number is 6/8/2009 and was last updated on 8/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	FLORIDA	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D5797	MEDICARE UPIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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